Individual
MS. MELISSA OVALLES TEJADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2825 EAST BARMETT RD, MEDFORD, OR 97504
(541) 789-7000
Mailing address
PO BOX 4749, MEDFORD, OR 97501-0227
(541) 789-7000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202103250NP-PP
OR
363LF0000X
Family Nurse Practitioner
766077
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
766077
RN LICENSE
CA
Enumeration date
10/26/2011
Last updated
07/09/2021
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